Exploring the Utilization of and Outcomes from Health Information Exchange in Emergency Settings (Indiana)

Project Details - Ongoing

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Health information exchange (HIE) involves the electronic exchange of health data across institutions, data repositories, and States. Widespread HIE use has the potential to improve care and reduce information deficits, the lack of which can result in decreased quality of care, redundant testing, care delays, and potentially avoidable admissions. The emergency department (ED) is an ideal care setting to evaluate HIE usage because visits are mostly unplanned, urgent and acute, and patient health information is not available beforehand to providers. Almost 70 percent of hospital admissions for Medicare beneficiaries originate in the ED, of which many may be avoidable if comprehensive information was available to clinicians.

Although HIE is perceived to be critical to healthcare delivery and health system reform, most studies focus on whether institutions have purchased and installed HIE functionality, not on actual HIE use. This project will examine HIE use among ED staff using data captured within the Indiana Network for Patient Care (INPC), an operational community-based HIE network, to better understand usage and impact. Researchers aim to strengthen the evidence base on HIE usage by conducting an objective and longitudinal analysis of frontline staff user behavior, as well as an analysis of the facilitators and barriers to usage in the context of emergency care.

The specific aims of the project are as follows:

  • Characterize HIE use within a mature HIE over time. 
  • Explore the antecedents to HIE use. 
  • Quantify the association between HIE use and potentially avoidable utilization of health care services. 

Researchers will examine HIE usage with longitudinal log data from the INPC and measure its impact on outcomes first in all care settings, and then specifically in EDs to provide a deeper focus. They will use semi-structured interviews to elicit factors that either facilitate or act as a barrier to HIE use among ED users. Investigators will explore the impact of HIE use on admissions, laboratory testing, and other healthcare quality measures. Knowledge gained from the project will create generalizable methods for understanding HIE use and the impact of use on healthcare delivery, as well as clinical and population health outcomes.

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